Medicine and Health Sciences Commons^™

Bioprosthetic Aortic Valve Endocarditis In Association With Enterococcus Durans, Luca Fallavollita, Lorena Di Gioacchino, Fabrizio Balestrini

The Texas Heart Institute Journal

Enterococci are common organisms associated with endocarditis, but infection by Enterococcus durans is very rare. To our knowledge, only 3 cases have been reported in the medical literature, and all 3 have involved native valves. Here we publish the first reported case (to our knowledge) of E. durans endocarditis in association with a bioprosthetic aortic valve. After the organism and its antibiotic susceptibility were identified, the 74-year-old male patient was treated successfully with teicoplanin and gentamicin, over a course of 6 weeks.

Georgia Latino Enrollment In The Affordable Care Act: A Qualitative, Key Informant Analysis, Audrey Mcculloch, Dabney P. Evans

Journal of the Georgia Public Health Association

Background: Prior to implementation of the Affordable Care Act (ACA) in 2010, one in three Latinos in the United States were uninsured. In Georgia, a state that established a federal Marketplace, nearly half of Latinos lacked health insurance coverage going into the initial enrollment period of October 1, 2013 to April 15, 2014. The ACA provided an opportunity for these uninsured Latinos to gain health insurance coverage, thus increasing their access to necessary medical services. The purpose of this qualitative study was to explore, from the perspective of key informants, knowledge of Georgia Latinos about the ACA and perceived barriers …

Perceptions Of Medical Students Regarding Dimensions Of Environmental Wellness, Shahjahan Katpar, Rakhshaan Khan, Rabia Siddiqu, Mehwish Hussain, Rehana Rehman

Department of Surgery Docs

Abstract

OBJECTIVE:

To explore the status of awareness on environmental wellness in medical students of Karachi.

METHODS:

The cross-sectional questionnaire-based survey was carried out at Bahria University Medical & Dental College, Karachi, from January 2009 to July 2013, and comprised randomly selected medical students. The response options were; never, sometimes, mostly and always (numbered 0-4) and these were analyzed in terms of frequency, proportion and percentages by Predictive analysis software version18.

RESULTS:

Out of 800 questionnaires distributed, 736(92%) were received fully completed. There were 210(28.5%) male and 526(71.5%) female respondents, with a male-to-female ratio of 1:2.5. Female medical students were …

The Neural Encoding Of Cocaine-Induced Devaluation In The Ventral Pallidum, Chung-Lung Chan, Daniel S. Wheeler, Robert A. Wheeler

Biomedical Sciences Faculty Research and Publications

Cocaine experience affects motivation structures such as the nucleus accumbens (NAc) and its major output target, the ventral pallidum (VP). Previous studies demonstrated that both NAc activity and hedonic responses change reliably as a taste cue comes to predict cocaine availability. Here we extended this investigation to examine drug-experience induced changes in hedonic encoding in the VP. VP activity was first characterized in adult male Sprague–Dawley rats in response to intraoral infusions of palatable saccharin and unpalatable quinine solutions. Next, rats received 7 daily pairings of saccharin that predicted either a cocaine (20 mg/kg, ip) or saline injection. Finally, the …

Dietary Nitrate In Decreased Blood Pressure In Obstructive Sleep Apnoea Syndrome: A Series Of N-Of-1trials, Conor Kerley, Liam Cormican, Eamon Dolan

Articles

Obstructive sleep apnoea syndrome (OSAS) is a consequence of repetitive oropharyngeal airway narrowing/closure during sleep resulting in chronic intermittent hypoxaemia [1]. OSAS is regarded as an independent risk factor for hypertension (HTN) development [2] and is associated with decreased cerebral blood flow [3], leading to daytime neuropsychological sequelae [1]. Blood pressure (BP) follows a circadian rhythm termed dipping and the absence of nocturnal BP dipping is associated with target-organ damage, cerebrovascular disease, myocardial remodelling and increased cardiovascular events/mortality [4]. Abnormal BP in OSAS typically manifests as reduced nocturnal BP dipping [5]. Although continuous positive airway pressure therapy (CPAP) represents the …

Can A Home-Based Cardiac Physical Activity Program Improve The Physical Function Quality Of Life In Children With Fontan Circulation?, Roni M. Jacobsen, Salil Ginde, Kathleen Mussatto, Jennifer Neubauer, Michael G. Earing, Michael E. Danduran

Exercise Science Faculty Research and Publications

Objective

Patients after Fontan operation for complex congenital heart disease (CHD) have decreased exercise capacity and report reduced health-related quality of life (HRQOL). Studies suggest hospital-based cardiac physical activity programs can improve HRQOL and exercise capacity in patients with CHD; however, these programs have variable adherence rates. The impact of a home-based cardiac physical activity program in Fontan survivors is unclear. This pilot study evaluated the safety, feasibility, and benefits of an innovative home-based physical activity program on HRQOL in Fontan patients.

Methods

A total of 14 children, 8–12 years, with Fontan circulation enrolled in a 12-week moderate/high intensity home-based …

Intraspinal Drug Delivery Reservoir Refill Procedure By Non-Physician Clinicians: A Nation-Wide Survey Of Training, Pocket Fill Experience, And Life-Long Learning Behaviors, Gail Mcglothlen

Doctoral Projects

Intraspinal drug delivery (IDD) is a safe and efficacious method used to deliver medications for the treatment of chronic neurologic disease that requires periodic reservoir refills that can place patients at risk for a rare, accidental but potentially life-threatening, pocket fill. In the United States (US), non-physician clinicians perform this procedure. This study reports the results of a nationwide survey completed by 65 non-physician clinicians, obtained through social media, who performed the reservoir refill procedure. The results of the survey showed no standardized training was used, lack of attention to existing clinical practice guidelines in the training given, lack of …

Exploring The Needs And Preferences For A Diabetes Self-Management Program In Hispanics Living In The Central Valley Of California, Emily Lane Kimble

Doctoral Projects

Diabetes mellitus type 2 is an ever increasing threat to the health of people living in the United States, especially those of Hispanic ethnicity. This ethnic group is disproportionately afflicted with the chronic condition and is also more likely than non-Hispanic whites to suffer from serious complications of diabetes. This project examines this growing problem among Hispanics living in the Central Valley of California by exploring how best to structure diabetes self-management education in a network of community health centers.

The Social Cognitive Theory provides a theoretical basis for investigation into motivation for diabetes self-management. This needs assessment specifically explored …

Constructivist Learning Strategies In A Nurse Residency Program, Floyd M. Hammon Iii

Doctoral Projects

Nurses are knowledge workers in technologically advanced social environments providing care to patients with complex biopsychosocial health care needs. The Nurse Residency Program (NRP) is a transition to practice program designed to facilitate the professional socialization of the newly licensed registered nurse (NLRN) with the goal of developing competency in providing safe and quality patient-centered care. Constructivist learning strategies are an instructional framework that promotes social facilitated self-directed learning. The purpose of the project is to determine if using constructivist learning strategies are an effective learning method in a NRP as measured by the Casey-Fink Graduate Nurse Experience Survey.

The Effectiveness Of California Assembly Bill 2109: Personal Belief Exemptions For Kindergarten Immunizations, Lilli Shizuka Goishi-Bessey

Doctoral Projects

The numbers of vaccine preventable diseases (VPDs) in the United States has declined with the development, administration, and effectiveness of vaccines during the 1970s and 1980s. As the eminent threat of VPDs to the public began to wane, parents started questioning the safety and necessity of vaccines. When parents were given the option of selecting personal belief exemption (PBE) waivers for state mandated immunizations for their incoming kindergarten children, an increase in PBEs and the number of VPD outbreaks began to occur. To counter the growing trend of PBEs, and to prevent outbreaks of VPDs in school settings and communities, …

A Phenomenological Assessment Of Factors That Affect Medication Adherence Among Hypertensive Nigerian Immigrants, Beulah Iroegbu

Doctoral Projects

This qualitative study explored the perceptions that affect medication adherence among hypertensive Nigerian immigrants in Sacramento, California. The research questions focused on factors that influenced the adherence to hypertension medication; specifically, how the sample population explained the cause of hypertension and whether culture and religion impacted the cause and management of hypertension. A phenomenological approach was used to understand perceptions about medication adherence. A predefined group of 9 acted as a purposive sample and was given semi-structured individual interviews. Qualitative data analysis of the interviews was performed using Colaizzi's 7-step method. Results from the study found the cause of hypertension …

Labrad : Vol 42, Issue 1 - April 2016, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Biochemical Bone Profiles Available at Clinical Laboratoryof Aga Khan University Hospital
• Ionized Calcium Determination in Clinical Labortory
• Parathyroid Hormone Disorders and Issues of Testing
• Tubular Maximum Reabsorption Rate of Phosphate to Glomerular Filtration Rate (TmP/GFR)
• Renal Osteodystrophy: A Disturbed Metabolic Aspect of Renal Failure
• Update on Microbiological Diagnosis of Bone and Joint Disorders
• Classification of Tumours of Bone : An Update Based on the 2013 World Health Organization Classification of Tumours of Soft Tissue and Bone
• Recent Developments in Benign Bone Tumours
• Role of Clinical and Radiological Correlation in Orthopaedic Pathology
• CME Seminar on ‘World Osteoporosis Day’

Women’S Views On The Challenges And Solutions In Preventing The Gendered Spread Of Hiv In Masxha, Cato Manor, Paige Mcmahon

Independent Study Project (ISP) Collection

Despite numerous national prevention efforts, South Africa remains at the epicenter of the HIV/AIDS epidemic. The burden of the epidemic is extremely heterogeneous, with province, race, gender, age, and socioeconomic status serving as key variables in determining HIV prevalence rates. Black African women are disproportionately affected by the epidemic, with those between the ages of 20 and 34 having an HIV prevalence rate of 31.6%, the highest in the country (Shisana et al., 2014). The purpose of this study was to engage with black African women about the challenges they believe women face in protecting themselves against HIV, and potential …

Needle Exchange Programs And Hiv/Aids: A Comparison Of The Use Of Harm Reduction Methods In Switzerland And The United States Of America, Margaret House

Independent Study Project (ISP) Collection

This paper explores the connections between needle exchange programs and rates of HIV/AIDS in Switzerland and the United States of America. While these two countries are very similar in their general political philosophies, they have some key cultural and historical differences which has shaped their responses to HIV/AIDS and injection drug use. Switzerland’s unique experience with a very open injection drug use scene in the 1980s guided this country to a more pragmatic, harm reduction-based response. By contrast, United States responded to the AIDS epidemic that struck violently in the 1980s with a mix of fear and denial. Though both …

Migrant Access To Healthcare: A Study Of Undocumented Migrant Access To Sexual Healthcare & Family Planning Services In Switzerland In 2016, Emily Egbert

Independent Study Project (ISP) Collection

The Swiss healthcare system has experienced a significant influx of vulnerable migrants over the past few years. This presents a challenge to providers and policy makers to account for and provide aid to these non-­‐ Swiss citizens, such as undocumented migrants (UDM), whose status and circumstances may impede their access to healthcare. Along with this, various cultural barriers may present further challenges to access to the health system. This paper explores UDM access to health through the lens of sexual healthcare and family planning. In examining sexual health, the issues of sexually transmitted infections (STIs), HIV/AIDS, and sexual violence were …

A Precarious Paradigm: Seeking Alternatives To Public-Private Partnerships In Health, A Case For The Code, Lena Mininberg

Independent Study Project (ISP) Collection

Background: Breastfeeding is an unparalleled source of nutrition for infants and young children and is recommended as the best practice universally by the World Health Organization (WHO). The benefits in human health and development that result from exclusive and sustained breastfeeding have enormous economic development potential. Because of the non-legally binding nature of the International Code of Marketing of Breastmilk Substitutes (the Code), and shifting socio-cultural norms, breastfeeding rates are at an alarming low. In order to progress towards the Sustainable Development Goals, breastfeeding practices must be protected, promoted, and supported worldwide.

Objective: This research paper explores implementing strong measures …

Capacity Building Of Health Workforce: Investigation Of Training Process For Community Health Volunteers (Chvs) Serving Refugee Populations In Host Communities, As Perceived By Participants And Trainers, Jerusalem Hadush

Independent Study Project (ISP) Collection

The health system in the Hashemite Kingdom of Jordan, which hosts 1.4 million refugees from the Syrian Arab Republic—more than 636,000 of whom are registered with UNHCR—is over-extended (UNHCR, 2016). Non-governmental organizations fill gaps in service delivery by injecting health personnel to deliver care, however, nationals and refugees must be integrated in the response to ensure sustainable health care delivery (UNHCR Handbook for Emergencies, 2007). Leveraging the capacities of lay citizens and refugees by task shifting and training CHVs can alleviate the increased health burden. Research into training programs is significant because the quality of training is directly related to …

Healthcare Access For Syrian Refugees Lacking Legal Documentation In Jordan, Caroline Flynn

Independent Study Project (ISP) Collection

The purpose of this study is to analyze the access and utilization of health care services by Syrian refugees lacking documentation. This study focuses on the current procedures utilized by healthcare providers for addressing lack of legal documentation in their Syrian refugee patients, as well as broader policies and strategies for addressing the status and protection of these undocumented individuals. This study grapples with the relationship between legal documentation and access to services. The increased costs and barriers to healthcare that come with stateless and refugee status may influence health outcomes and socioeconomic opportunities that impact these individuals for the …

Los Rompecabezas Del Enfoque Intercultural: El Estado Actual, La Integración De Los Sistemas De Salud Indígena Y Convencional Y El Estancamiento De La Transversalización En El Centro De Salud De Huancarani, Kasey Sumeriski

Independent Study Project (ISP) Collection

Para mi proyecto de ISP, estudiaba y analizaba la funcionalidad de medicina intercultural, así como aquellos elementos que faciliten la integración de los sistemas de medicina tradicional y medicina convencional y se requiere analizar de qué manera se concreta la transversalización del enfoque intercultural en el Centro de Salud de Huancarani, Cusco, Perú. Este tema es de importancia para el Ministerio de Salud de Perú, que aprueba la Política Sectorial de Salud Intercultural mediante el Decreto Supremo 016-2016, para “que se favorezca la inclusión, equidad e igualdad de oportunidades” de salud. Además, este tema es un enfoque respaldado por investigaciones …

One Year Later: The Politics And Stories Of Post-Earthquake Nepal, Boyer Andrew

Independent Study Project (ISP) Collection

A 7.8 magnitude earthquake struck Nepal on April 25^th, 2015. This was followed by a second major earthquake of magnitude 7.3 on May 12^th , 2015. These disasters took the lives of thousands of Nepali people, destroyed hundreds of thousands of structures, and displaced an estimated two million people. Immediately following the disaster, there was an outpouring of humanitarian aid from around the world. This lead to a conference where $4.1 billion USD of reconstruction funds were pledged to Nepal by international donors. Five months later, a new constitution passed into law and an informal blockade of …

J Am Coll Dent 2016 83 2

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

The Need For Culturally-Tailored Smartphone Applications For Weight Control, Stephen S. Coughlin, Dale Hardy, Lee S. Caplan

Journal of the Georgia Public Health Association

Background: Approximately 35% of U.S. adults are obese, and this rate is expected to increase by almost 50% by 2030. New media such as smartphone applications (apps) provide a useful and low-cost way to disseminate weight control information. For many culturally distinctive population subgroups, however, there is currently an absence of research-tested smartphone apps for weight control.

Methods: In this commentary, we highlight the need for culturally tailored smartphone apps for weight control and offer recommendations for further research by providing two specific examples: 1) the characteristic dietary patterns and absence of smartphone apps for weight loss for Hispanic Americans, …

Factors Associated With Body Mass Index Among African American Breast Cancer Survivors, Selina A. Smith, Mechelle D. Claridy, Mary S. Whitehead, Joyce Q. Sheats, Wonsuk Yoo, Ernest Alema-Mensah, Benjamin E. Ansa, Ronald L. Braithwaite

Journal of the Georgia Public Health Association

Background: Weight gain after diagnosis and treatment is common among breast cancer survivors (BCSs). Little information exists regarding associations between body mass index (BMI) and lifestyle factors and health-related quality of life (HR-QoL) among African American (AA) BCSs. The present study sought to determine associations between BMI, dietary intake, and physical activity as lifestyle modification strategies and HR-QoL among AA BCSs.

Methods: For this cross-sectional study, a lifestyle assessment tool was administered to 195 AA BCSs. Possible predictor variables included socio-demographic and medical characteristics, dietary intake and physical activity patterns, and physical health. The outcome variable was BMI.

Results: Many …

A Quantile Regression Approach To Measuring The Educational Effect On Body Mass Index, Dakshina G. De Silva, Bradley T. Ewing, Catherine P. Slade, Mark A. Thompson

Journal of the Georgia Public Health Association

Background: By use of a publically available database, the effects of education and geography on obesity as measured by body mass index (BMI) were evaluated with a quantile regression approach. The focus of the analysis was on the practical interpretation of the regression results to inform health policy decision makers about the importance of educational attainment for the growing public health issue of obesity in the US, particularly in the Southeast.

Methods: With data from the 2007 Behavioral Risk Factor Surveillance System (BRFSS), quantile regressions were employed to estimate the educational effect on BMI while controlling for relevant lifestyle, socioeconomic, …

A Systematic Review Of Lifestyle Interventions For Chronic Diseases In Rural Communities, Selina A. Smith, Benjamin Ansa

Journal of the Georgia Public Health Association

Background: Rural Americans suffer disproportionately from lifestyle-related chronic diseases (e.g., obesity, diabetes, hypertension, cardiovascular disease, and breast cancer). Interventions that consider the distinctive characteristics of rural communities (e.g., access to healthcare, income, and education) are needed. As an initial step in planning future research, we completed a systematic review of dietary intake and physical activity interventions targeting rural populations.

Methods: Manuscripts focused on dietary intake and physical activity and published through March 15, 2016, were identified by use of PubMed and CINAHL databases and MeSH terms and keyword searches.

Results: A total of 18 studies met the inclusion criteria. Six …

Demographic And Socioeconomic Factors Associated With Hpv Vaccination In Georgia’S South Central Health District, Sydney Ekeledo, Candace Best, Stephanie Norman, Jodi Bazemore, Jessica Smith Schwind

Journal of the Georgia Public Health Association

Background: Human Papillomavirus (HPV) subtypes are the primary cause of cervical cancer. Despite introduction of the HPV vaccine in 2006, vaccination percentages remain low across Georgia counties. The primary objective of this research was to conduct a descriptive epidemiological study of HPV vaccination coverage among individuals in the South Central Health District (SCHD) to provide guidance for targeted vaccination campaigns aimed at adolescents residing in rural communities.

Methods: Data from the Georgia Registry of Immunization Transactions and Services and AEGIS.net, Inc. were used to analyze demographic and socioeconomic factors associated with HPV vaccine uptake among individuals visiting county health departments …

Characteristics Of Rural Users Of Emergency Medical Services In Georgia: A Population-Based Study, Nannette Turner, Huey Chen, Liliana Morosanu

Journal of the Georgia Public Health Association

Background: Emergency medical services (EMS) are an essential part of health care. Appropriate information about EMS usage in rural areas will allow effective utilization of EMS resources for their intended purpose, and at the state level, drive the adoption of better EMS policies to ensure and maintain equitable access to these health services in rural areas.

Methods: The present study, performed by analyzing data from the Georgia Emergency Medical Services Information System (GEMSIS), describes the population using EMS in rural Georgia. Distributions of rural EMS transports are reported, along with usage for selected population groups based on race, gender, age …

A Comparison Of Hospital Utilization In Urban And Rural Areas Of South Carolina, Vivian G. Dicks

Journal of the Georgia Public Health Association

Background: Previous studies have described health care utilization based on insurance status and ethnicity. Few investigations, however, have looked at rural populations in relation to distance in securing health care.

Methods: The 2008 to 2009 Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) for South Carolina was used to assess the relationship of living in rural versus urban communities and the demographic variables related to insurance coverage. By use of bivariate and multivariate analyses, patient socio-demographic characteristics were explored for working-aged groups in relation to their income and for payer status (Medicaid or uninsured) relative to those privately …

Leveraging University-Community Partnerships In Rural Georgia: A Community Health Needs Assessment Template For Hospitals, Ayanna Robinson, Sabrina T. Cherry, Michelle Elliott, Marsha Davis, Grace Bagwell

Journal of the Georgia Public Health Association

Background: Under the Affordable Care Act, nonprofit hospitals are required to conduct a Community Health Needs Assessment (CHNA) every three years. Using recommendations proposed by Georgia Watch, students and faculty members from the University of Georgia (UGA) conducted a CHNA for a hospital in a rural county in Georgia. The purpose of the CHNA was to identify community health problems and needs, as well as community assets and resources. The aim of this report is to describe the process for conducting the CHNA, the findings, and the lessons learned.

Methods: The CHNA team consisted of students and faculty members from …

Colorectal Cancer In Nonagenarians: Treatment Decisions And Outcomes, Daniel Meikle Md, Martin Alvarez Md, Mark Wiseman Md, John S. Park Md

Department of Surgery

No abstract provided.